Pilot study shows that antibody cetuximab can be used safely and effectively for patients with glioblastoma to aid tumor removal.

Glioblastoma, an aggressive form of cancer that occurs most often in the brain, cannot be removed completely with surgery because of its diffuse nature. The tumor grows into the normal brain tissue, and as a result, its edges are difficult to distinguish for surgeons. However, a more complete resection of the glioblastoma tends to correlate with longer progression-free survival.

To that end, a team of researchers from Stanford University School of Medicine recently tested the ability of near-infrared fluorescence imaging with the antibody cetuximab to better identify cancerous tissue in patients with glioblastoma. For this first test in humans, Cetuximab-IRDye800 imaging proved to be safe with no adverse events and successfully distinguished tumor from normal tissue. The results were presented at American College of Surgeons Clinical Congress 2017 in October.

The method uses a near-infrared fluorescent dye (IRDye800) conjugated with cetuximab, a monoclonal antibody that binds to the epidermal growth factor receptor found in cancer cells in high levels. Three patients with glioblastoma were injected with escalating doses of Cetuximab-IRDye800 two to five days before surgery. Near-infrared imaging revealed highly specific fluorescence for viable tumor tissue, while normal tissue around the tumor showed minimal fluorescence.

The pilot study demonstrates the feasibility of Cetuximab-IRDye800 imaging—which combines a standard piece of imaging equipment in operating rooms with an already-approved antibody—for glioblastoma. The next step in bringing this technology to more patients will be a large prospective study.